Autism insurance coverage: California is one step closer to law

Autism insurance coverage

California advocates and families of children with autism had reason to celebrate this week as Senate President pro Tem Darrell Steinberg introduced amended legislation that would provide individuals with autism and pervasive developmental disorders access to insurance coverage for services, including Applied Behavioral Analysis (ABA) and other intensive early intervention therapy.

In a press release issued by Senator Steinberg he said, “Parents of autistic children shouldn’t have to spend their days and sleepless nights battling with insurance companies because of a lack of clarity regarding this highly effective therapy. ABA has long been considered medically necessary and has proven remarkably effective for a majority of families.”

According to May 2011 data from the National Conference of State Legislatures a total of 33 states and the District of Columbia have laws related to autism and insurance coverage. At least 26 states—Arizona, Arkansas, Colorado, Connecticut, Florida, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, Pennsylvania, South Carolina, Texas, Vermont, Virginia, West Virginia and Wisconsin—specifically require insurers to provide coverage for the treatment of autism. “Thanks to the efforts of Senate President pro Tem Steinberg, California is one step closer to joining the distinguished list of other states with legislation,” said Sheryl Young, CEO of AbilityPath. “As advocates, parents, health professionals and educators, we need to partner and lean on our legislators until all 50 states have laws that end the unequal coverage.”

Raising a child with special needs comes with several financial strains to the family. Studies have reported that several dual income families have had to go down to single income households due to the demands of therapy and medical appointments as well as numerous other meetings needed to coordinate services and educational placements. The intensity of services prescribed to children with autism increases that financial commitment. A 2006 Harvard study estimated the cost of raising a child with autism to be $3.2 million in comparison to the $290,000 it reportedly costs to raise a neurotypical child.

The California legislation, SB 770, that was just introduced will offer some relief to the more than 18,000 California families caring for children with autism who are now forced to pay out-of-pocket for such treatments. Additionally the bill expands the list of qualified autism providers to include any licensed or nationally certified professional, or any provider of services approved as a vendor by one of California’s 21 non-profit regional centers.

If your state is not among those with autism insurance reform legislation, AbilityPath encourages you to send an email or letter to your state representative encouraging they join California and the other states pursuing such law. Find your legislator. Download sample email/letter to legislators regarding autism insurance coverage.